Neuromuscular Conditions
Summary
Weakness may precipitate Intensive Care Unit (ICU) admission, and can result from generalised disease states (such as malnutrition), critical illness (such as severe sepsis) or those specific states which primarily affect the neuromuscular system e.g. myasthenia gravis, Guillain–Barré Syndrome (GBS).
Weakness may result from impacts on upper or lower motor neurones (in isolation or with involvement of other peripheral or central nervous system elements), motor end plates (neuromuscular transmission), or skeletal muscle itself. Whatever the cause, ICU admission related to such conditions generally results from respiratory muscle weakness and/or difficulty in swallowing, with consequent aspiration. Early recognition and intervention is crucial: death can result from ventilatory failure and/or aspiration pneumonia, and the autonomic instability which complicates some conditions.
Weakness as a result of neuromuscular conditions can also complicate critical illness, increasing the duration of mechanical ventilation and ICU and hospital stay, and causing post-discharge morbidity and mortality.
You will find the following references helpful in understanding the broad range of neuromuscular conditions encountered in the ICU.
General Information
Enrolled trainees 2025
Open 07.05.2018
Available for ESICM members
Student effort 3
Last Updated July 9, 2024
Intended Learning Outcomes
After studying this module on Neuromuscular Conditions, you should be able to:
- Identify causes of acute weakness.
- Be familiar with the assessments and differential diagnosis in acute weakness.
- Recognise the common acute and subacute causes of neuromuscular weakness leading to ICU admission. Understand their prognosis and treatment.
- Recognise the causes of acute weakness appearing after ICU admission. Understand their prognosis and treatment.
Relevant competencies in CoBaTrICE
- 3.1 Manages the care of the critically ill patient with specific acute medical conditions
- 3.6 Recognises and manages the patient with neurological impairment
- 3.10 Recognises and manages the patient following intoxication with drugs or environmental toxins
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